Description

The birth of a baby can start a variety of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect-depression.

Most new moms experience postpartum "baby blues" after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues usually begin within the first 2 to 3 days after birth and can last up to two weeks.

But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Sometimes called peripartum depression, because it can begin during pregnancy and continue after birth. Rarely, an extreme mood disorder called postpartum psychosis may also develop after birth.

Postpartum depression is not a character flaw or a weakness. Sometimes it is simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms and help you bond with your baby.

Symptoms

The symptoms of depression after childbirth vary, and can range from mild to severe.

Baby blues symptoms

The symptoms of the baby blues — which last only a couple of days to a week or two after your baby is born — may include:

  • Mood swings
  • Anxiety
  • Sadness
  • Irritability
  • Feel overwhelmed
  • Crying
  • Reduction of the concentration
  • Appetite problems
  • Sleep problems

The symptoms of postpartum depression

Postpartum depression may be mistaken for baby blues at first— but the symptoms are more intense and last longer. These, finally, it can interfere with your ability to take care of your baby and handle other daily tasks. The symptoms usually develop within the first few weeks after giving birth. But you can start earlier — during pregnancy — or later — up to a year after birth.

Postpartum depression symptoms may include:

  • Depressed mood or severe mood swings
  • Cry too
  • Difficulty bonding with your baby
  • Withdrawal from family and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep, called insomnia, or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Less interest and pleasure in activities you used to enjoy.
  • Intense irritability and anger
  • The fear that you're not a good mother
  • Hopelessness
  • Feelings of worthlessness, shame, guilt or inadequacy
  • Decreased ability to think clearly, concentrate or make decisions
  • The concern
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

Without treatment, postpartum depression can last for many months or more.

Postpartum psychosis

With postpartum psychosis — a rare condition that usually develops within the first week after delivery — the symptoms are severe. Symptoms may include:

  • Feeling confused and lost
  • Having obsessive thoughts about your baby
  • Hallucinating and having delusions
  • Have trouble sleeping
  • Have too much energy and feeling of discomfort
  • Paranoia
  • To do with the attempts of harming yourself or your baby

Postpartum psychosis can lead to life-threatening thoughts or behavior, and requires immediate treatment.

Postpartum depression in the other parent

Studies show that new parents can experience postpartum depression, too. They may feel sad, tired, overwhelmed, anxious, or have changes in your eating and sleeping. These are the same symptoms that mothers with postpartum depression experience.

Parents who are young, have a history of depression, the experience of the problems of the relationship or are struggling financially are at higher risk of postpartum depression. Postpartum depression in parents — sometimes called paternal postpartum depression, can have the same negative effect on the couple relationship and development of the child, such as postpartum depression in mothers.

If you're a partner of a new mother and you have symptoms of depression or anxiety during their partner's pregnancy or after the birth of your child, talk with your health care provider. Similar treatments and supports for mothers with postpartum depression can help to treat postpartum depression in the other parent.

When to see a doctor

If you feel depressed after the birth of your baby, you may be reluctant or embarrassed to admit it. But if you experience any of the symptoms of postpartum blues or postpartum depression, call your primary care doctor or your ob / gyn and schedule an appointment. If you have symptoms that suggest you may have postpartum psychosis, seek help immediately.

It is important to call your doctor as soon as possible if the symptoms of depression you have any of these features:

  • Not fade away after two weeks.
  • They are getting worse.
  • Make it difficult for you to take care of your baby.
  • Make it difficult to complete daily tasks.
  • Include thoughts of harming yourself or your baby.

If you have thoughts of suicide

If at any time you have thoughts of harming yourself or your baby, immediately seek the help of your partner or loved ones in the care of your baby. Call 911 or your local emergency number for assistance.

Also consider these options if you are having suicidal thoughts:

  • Seek help from a health professional.
  • Call a mental health provider.
  • In contact with a direct line of suicide. In the united states, call or text 988 to reach the 988 Suicide and Crisis Lifeline is available 24 hours a day, seven days a week. Or use the Lifeline Chat . The services are free and confidential. The Suicide and Crisis Lifeline in the united states has a Spanish language of the phone line in 1-888-628-9454 (toll-free).
  • Reaching out to a friend or loved one.
  • Contact a minister, spiritual leader or someone in your faith community.

Helping a friend or loved one

People with depression may not recognize or admit that they are depressed. You may not be aware of the signs and symptoms of depression. If you suspect that a friend or a loved one suffers from postpartum depression or is the development of postpartum psychosis, help them to seek medical attention immediately. Do not wait and hope for improvement.

Causes

There is No single cause of postpartum depression, but the genetic, physical and emotional changes may play a role.

  • Genetics. Studies show that having a family history of postpartum depression — especially if it is larger increases the risk of postpartum depression.
  • The physical changes. After childbirth, a dramatic drop in the hormones estrogen and progesterone in the body can contribute to postpartum depression. Other hormones produced by the thyroid gland can also drop sharply — that can make you feel tired, sluggish and depressed.
  • Emotional problems. When we are sleep deprived and overwhelmed, you may have difficulty to handle even minor problems. You may be anxious about their ability to take care of a newborn. You may feel less attractive, struggle with their sense of identity or feeling that you have lost control of your life. Any of these problems can contribute to postpartum depression.

Risk factors

Any new mom can experience postpartum depression, and it can develop after the birth of any child, not just the first. However, the risk increases if you:

  • You have a history of depression, either during pregnancy or at other times.
  • You have bipolar disorder.
  • I had postpartum depression after a previous pregnancy.
  • You have family members who have had depression or other mood disorders.
  • You have experienced stressful events during the past year, such as complications of pregnancy, illness or loss of employment.
  • Your baby has health problems or other special needs.
  • Of having twins, triplets and other multiple births.
  • You have difficulty breastfeeding.
  • Are you having problems in your relationship with your spouse or partner.
  • Has a weak support system.
  • You have financial problems.
  • The pregnancy was unplanned or unwanted.

Complications

Left untreated, postpartum depression can interfere with the bonding between mother and child and may cause problems in the family.

  • For the mothers. Without treatment, postpartum depression can last for months or more, sometimes becoming a course of a depressive disorder. Mothers can stop breastfeeding, have problems linking and care for their babies, and to be at higher risk of suicide. Even when it comes to postpartum depression increases a woman's risk of future episodes of major depression.
  • By the other parent. Postpartum depression can have a domino effect, causing emotional stress to all of you who are close to a new baby. When the mother is depressed, the risk of depression in the baby's other parent may also increase. And these other parents may have a greater risk of depression, whether or not your partner is impacted.
  • For the children. The children of mothers with no treatment of postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, crying too, and delays in language development.

Prevention

If you have a history of depression, especially postpartum depression — tell your doctor if you are planning to become pregnant or as soon as you know you are pregnant.

  • During pregnancy, your doctor can monitor you closely for symptoms of depression. You can fill in a depression-screening questionnaire during pregnancy and after childbirth. Sometimes mild depression can be managed with support groups, counseling, and other therapies. In other cases, antidepressants may be recommended — even during pregnancy.
  • After your baby is born, your doctor may recommend an early postpartum checkup to detect symptoms of postpartum depression. The earlier it's detected, before the start of the treatment. If you have a history of postpartum depression, your doctor may recommend treatment with antidepressants or psychotherapy immediately after delivery. The majority of antidepressants are safe to take during breastfeeding.

Diagnosis

Your doctor will usually talk to you about your feelings, thoughts and mental health to help determine if you have a short-term in case of postpartum "baby blues" or a more severe form of depression. Let him not be ashamed — postpartum depression is common. Share your symptoms with your doctor so that you and your provider can create a useful treatment plan.

As part of your evaluation, your health care provider can make a detection of depression, including the fact that they have to fill out a questionnaire. Your healthcare provider may order other tests, if necessary, to rule out other causes of your symptoms.

Treatment

The treatment and the recovery time varies, depending on the severity of your depression and what their needs are. If you have an underactive thyroid or an underlying disease, the doctor may treat these conditions or refer you to the appropriate specialist. Your health care provider may also refer you to a mental health professional.

Baby blues

The baby blues usually go away by themselves within a couple of days to 1 to 2 weeks. In the meantime:

  • Get as much rest as you can.
  • Accept help from family and friends.
  • Connect with other moms.
  • Create time to take care of himself.
  • Avoid alcohol and recreational drugs, which can make mood swings worse.
  • Ask your health care provider about how to get help from a health professional called a lactation consultant if you are having problems with the production of milk or breast-feeding.

Postpartum depression

Postpartum depression is often treated with psychotherapy — also called talk therapy, or mental health counseling, medicine, or both.

  • Psychotherapy. It can help to talk about your concerns with a psychiatrist, psychologist or other mental health professional. Through therapy, you can find better ways to deal with your feelings, solve problems, set realistic goals, and respond to situations in a positive way. Sometimes the family or relationship therapy also helps. Examples of therapies that are used for postpartum depression include cognitive-behavioral therapy (CBT) and interpersonal psychotherapy.
  • Antidepressants. Your health care provider may recommend an antidepressant. If you are breast-feeding, any medication you take is going to enter the breast milk. However, most of the antidepressants can be used during lactation, with little risk of side effects for your baby. Work with your doctor to weigh the potential risks and benefits of certain antidepressants.
  • Other medications. When required, other medications can be added to your treatment. For example, if you have postpartum depression that includes severe anxiety or insomnia, a medicine against anxiety can be recommended for a short time.

Brexanolone (Zulresso) is the first drug approved by the Food and Drug Administration specifically for postpartum depression in adult women. Brexanolone slows down the rapid decline of certain hormones after birth that can lead to postpartum depression. Possible serious side effects require a stay in a health facility, and monitoring by a health care provider to receive the medication through a vein over 60 hours. Because of this, the treatment is not yet widely available.

Research continues on an oral medication for postpartum depression, with promising results. The medicine is being studied works in a similar way to brexanolone. But it could be taken daily as a pill, and you may not have the same serious side effects.

With appropriate treatment, postpartum depression, the symptoms tend to improve. In some cases, postpartum depression can continue and become long-term, which is called chronic depression. It is important to continue the treatment after you begin to feel better. Stopping treatment too soon can lead to a relapse.

Postpartum psychosis

Postpartum psychosis requires immediate treatment, usually in the hospital. Treatment may include:

  • Drugs. The treatment may require a combination of medications, such as antidepressants, antipsychotics, mood stabilizers and benzodiazepines to control your signs and symptoms.
  • Electroconvulsive therapy (ECT). If your post-partum depression is severe and the experience of postpartum psychosis, electroconvulsive therapy may be recommended if symptoms do not respond to medications. Electroconvulsive therapy (ect) is a procedure in which small electric currents are passed through the brain, intentionally from a brief seizure. ECT seems to cause changes in brain chemistry that can reduce the symptoms of psychosis and depression, especially when other treatments have failed.

A stay in the hospital for the treatment of postpartum psychosis may challenge the ability of a mother to breast-feed. This separation from the baby makes breastfeeding difficult. Your health care provider may recommend support for breastfeeding — the process of production of breast milk, while you're in the hospital.

Lifestyle and home remedies

In addition to professional treatment, you can do some things by yourself to build on your treatment plan, and help speed recovery.

  • Make healthy lifestyle choices. Include physical activity, such as a walk with your baby, and other forms of exercise in your daily routine. Try to get enough rest. Eat healthy foods and avoid the consumption of alcohol.
  • Set realistic expectations. Don't pressure yourself to do everything. Scale back your expectations for the perfect home. Do what you can and leave the rest.
  • Make time for yourself. Take some time to yourself and get out of the house. That can mean asking for a partner to take care of the baby, or arrange for a babysitter. Do something you enjoy, like a hobby or any form of entertainment. You can also schedule some time alone with your partner or friends.
  • To avoid isolation. Talk with your partner, family and friends about how you feel. Ask other mothers about their experiences. To break the isolation can help you feel human again.
  • Ask for help. Try to open up to the people close to you and let them know that you need help. If someone offers to take care of kids, take them on him. If you can sleep, take a nap, or maybe you can watch a movie or meet up for coffee with friends. You can also benefit from asking for help with the skills of parenting that can include care techniques to improve your baby's sleep and to soothe fussing and crying.

Remember, taking care of your baby includes taking care of yourself.

Coping and support

The already stressful, exhausting period following the birth of a baby is more difficult when depression occurs. But remember, postpartum depression is never the fault of anyone. It is a common medical condition that needs treatment.

Therefore, if you are having trouble coping with postpartum depression, talk with your health care provider. Ask your healthcare provider or a therapist about local support groups for new moms, or women who have postpartum depression.

The sooner you get help, the sooner you will be fully equipped to deal with the depression and enjoy your new baby.

Preparing for your appointment

After your first appointment, your doctor may refer you to a mental health provider that you can create the treatment plan with you. You may want to find a trusted family member or friend to join you to your appointment to help you to remember all information that is discussed.

What you can do

Before your appointment, make a list of:

  • The symptoms you have been experiencing and for how long.
  • All your medical problems, including physical health conditions and mental health, such as depression.
  • All the medicines you take, including prescription and over-the-counter medicines, vitamins, herbs and other supplements, and dosage.
  • Questions to ask your provider.

Questions may include:

  • What is my diagnosis?
  • What treatments can help me?
  • What are the possible side effects of the treatments that you are suggesting?
  • How much and how soon do you expect of me that the symptoms improve with treatment?
  • Is the medication you are prescribing safe to take while breastfeeding?
  • How much time do I need to be treated?
  • What lifestyle changes can help me manage my symptoms?
  • How often you should be seen for follow-up visits?
  • I'm in a higher risk of other mental health problems?
  • Am I at risk of this condition is recurrent if I have another baby?
  • Is there any way to prevent a recurrence if I have another baby?
  • Is there any printed material I can have? What sites do you recommend?

Don't hesitate to ask any other questions during your appointment.

What to expect from your doctor

Your health care provider or mental health provider may ask you some questions, such as:

  • What are your symptoms, and when do they start?
  • The symptoms continued to improve, or get worse with time?
  • Are the symptoms that affect your ability to take care of your baby?
  • Do you feel as bonded to your baby as you expected?
  • You can sleep when you have the chance and get out of bed when it is time to wake up?
  • How would you describe your level of energy?
  • Has your appetite changed?
  • How often would you say that you are feeling anxious, irritable, or angry?
  • He has had thoughts of harming yourself or your baby?
  • The amount of support they have in the care of your baby?
  • There are other important stress factors in your life, such as financial or relationship problems?
  • Have you been diagnosed with any other medical condition?
  • Have you ever been diagnosed with any mental health condition, such as depression or bipolar disorder? If so, what type of treatment helped the most?

Your doctor may ask additional questions based on your responses, symptoms, and needs. Preparation questions will help you get the most out of your appointment.

Symptoms and treatment of Postpartum depression